The Surgical Repair of Posterior Urethral Strictures by the Transpubic Urethroplasty or Pull-Through Technique

Abstract

The management of strictures of posterior urethra is reviewed in 75 adults and 19 children. Of the patients 66 were treated by a perineal pull through technique and 28 underwent a transpubic appraoch. The transpubic approach provided excellent exposure to the damage urethra with minimal morbidity, and good results were obtained in 89% of the children and 69% of the adults. Three patients had partial incontinence postoperatively but 2 recovered completely after 6 mo. With the perineal pull through technique, good results were achieved in 80% of the children and 66% of the adults. Worsening of sexual function was not seen in either treatment group as a consequence of the operation. As a result of this experience the transpubic approach is preferred in cases of complex urethral strictures, cases in which the length of the damaged urethra exceeds 3 cm or in small children, reserving the pulp-through technique for low-lying urethral strictures less than 3 cm long.